NPI | 1093073629 |
---|---|
Former Name | AMANDA M ROSEN |
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WA MD60668472) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OR MD166587) |
Enumeration Date | 2012-05-02 |
Last Update Date | 2019-12-15 |